Concerns of the Patients with Lower Limb Amputation During Transition from Hospital to Home: A Qualitative Study

Abstract

Background: Amputation of the lower limb leads to marked physical disability and brings a significant and dramatic alteration to the patient’s life. Life with a sudden disability after discharge at home is not easy for a patient who had undergone amputation both physically as well as psychologically. But how the patients perceive the period of discharge is still an untouched area in literature. Objective: To explore the concerns of the patients with lower limb amputation during transition from hospital to home. Methods: A phenomenological research study was conducted in the amputation clinic of a tertiary care center in North India. Participants were the patients who had undergone lower limb amputation after sudden trauma. The tool used was an interview schedule, which comprised of(a) personal profile of the patients and (b) in-depth interview topic guide. In-depth interviews were conducted until data saturation. After 14 interviews, no fresh responses were received, and therefore, data collection was stopped after 16 interviews. Data were analyzed using Colaizzi’s method of data analysis. Results: Based on the participants’ verbatim, a total of three themes and eight subthemes were extracted after data analysis. The main theme that emerged was different emotions at the time of discharge, and the subthemes extracted under this theme were “want to leave stressful environment of hospital,” “feeling more secure at hospital,” and “not willing for discharge—anxiety of facing society.” The second theme was “unexpected hardships in the home after discharge,” and subthemes extracted under this theme were “reactions of closed ones,” “facing reality of practical life-unimagined difficulties,” and “immediate comparison to previous healthy life.” The third theme that emerged was “the bright side of amputation,” and subthemes extracted under this theme were “understood the uncertainty of life” and “positive transformation in life.” Conclusion: The study findings highlighted that experience of each individual is unique. Therefore, an individualized and patient-tailored approach must be used while handling such patients. Furthermore, the life at home after amputation comes with multifaceted challenges. Hence, there is a need of rendering detailed discharge information and need-based counseling at the time of discharge.